The objective of this five year academic award is to develop Dr. Lindamer's skills as a researcher, educator, and clinician in geriatric psychiatry with a specialization in women's health issues, particularly the role of estrogen replacement therapy (ERT) in psychiatric disorders. The award will build on Dr. Lindamer's combined training in neurosciences, clinical psychology, and neuropsychology and on her background in clinical research and methodology in geriatric psychiatry. She has recently completed a two-year post-doctoral research fellowship in geriatric psychiatry. She has authored or co-authored a total of 12 articles that are published or in press and another one that has been recently submitted. In addition, she has made many presentations and has 15 abstracts. The aim of the award is to further her skills in the following areas: 1) knowledge of steroid hormones and their relationship to psychopathology, 2) design and implementation of clinical trials, 3) assessment of psychopathology, cognition and quality of life in older schizophrenic patients, and 4) women's health issues in older chronically mentally ill patients. These skills will be acquired by participation in a structured training plan, including relevant course work consultation with experts in psychopharmacology, geriatric psychiatry, women's health issues, and by designing and executing a project investigating the effect of estrogen augmentation of neuroleptic medication in postmenopausal women with schizophrenia. Specific aims of the proposed double-blind, parallel group study ar to examine the effects of ERT in conjunction with neuroleptic medication on psychopathology, cognition, an quality of life in postmenopausal women with schizophrenia. The relationship between estradiol levels an psychopathology, cognition, and quality of life will also be investigated. This training program will assist Dr. Lindamer in making the transition to an independent investigator at University of California, San Diego, as well as a teacher and clinician in geriatric psychiatry.